Key result
Angiography and intracoronary imaging-derived physiology indices provide accurate, wire-free alternatives to invasive fractional flow reserve for evaluating coronary artery stenosis severity.
Why the study?
To review the current state and potential clinical impact of angiogram-derived physiology for estimating functional significance without invasive pressure measurement.
Angiography- and imaging-derived physiological indices provide accurate, wire-free alternatives to invasive FFR, potentially simplifying the functional assessment of coronary artery disease in the catheterization laboratory.
May simplify functional assessment in the cath lab; leaves open need for prospective outcome validation.
Intracoronary physiology testing has evolved as a promising diagnostic approach in the management of patients with coronary artery disease. The value of hyperemic translesional pressure ratios to estimate the functional relevance of coronary stenoses is supported by a wealth of outcomes data. The continuing drive to further simplify this approach led to the development of non-hyperemic pressure-based indices. Recent attention has focused on estimating functional significance without invasively measuring coronary pressure through the measurement of virtual indices derived from the coronary angiogram. By offering a routine assessment of the physiology of all the major epicardial coronary vessels, angiogram-derived physiology has the potential to modify current practice by facilitating more accurate patient-level, vessel-level, and even lesion-level decision making. This article reviews the current state of angiogram-derived physiology and speculates on its potential impact on clinical practice, in continuation to the previously published article on coronary physiology in this journal.
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Reddy et al. (2023) conducted a review in Coronary artery disease. Angiography and intracoronary imaging-derived physiology indices vs. Wire-based Fractional Flow Reserve (FFR) was evaluated. Angiography and intracoronary imaging-derived physiology indices provide accurate, wire-free alternatives to invasive fractional flow reserve for evaluating coronary artery stenosis severity.
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